Individual
DR. JEREMY T LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14200 W CELEBRATE LIFE WAY, GOODYEAR, AZ 85338-3007
(623) 207-3000
(623) 207-3921
Mailing address
14200 W CELEBRATE LIFE WAY, GOODYEAR, AZ 85338-3007
(623) 207-3000
(623) 207-3921
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53065
MN
207RH0003X
Hematology & Oncology Physician
29227
NE
207RH0003X
Hematology & Oncology Physician
53065
MN
207RH0003X
Hematology & Oncology Physician
Primary
54266
AZ
Other
Enumeration date
08/13/2009
Last updated
01/04/2024
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